Chronic Illness Strikes Again Essay

Throughout the ‘hard times’ of a person’s life, they may face their difficulties with an attitude of generosity and fortitude. When it comes to living in sickness, however, true human nature seems to reveal itself. When confined to the house, room, or bed with a chronic illness, one becomes weak. This weakness allows themselves to show the nature of humans, which is not the aforementioned strength, but selfishness as well as impatience. Chronic illnesses have an extreme effect on the mindset of an individual. Affected children and adolescents are subjected to developmental issues, worries of being socially unaccepted, and being uncertain of their future. Children have been observed to experience more stress and far more changes in personality and behavior. Their risk for psychological disorders significantly increases in the presence of a severe illness. The limits put on chronically ill children, usually by parents or doctors, destruct their concept of manners an d ‘behaving’. This causes the child to be quick-tempered and prone to tantrums. Human selfishness is the underlying root of negative behavior changes due to sickness. Individuals with a chronic illness are viewed as a burden on society by the vast majority of our population. It is the healthy person’s own selfishness that causes the sick to be aware of everyone else’s ‘not my problem’ attitude. Sickness has a monumental impact on the person living in it and alters every aspect of their life. When a family member is suffering from a severe illness, the dynamic of their family will drastically change. Parents are primarily the caregivers to their children while they are sick. Their role is a challenging one, as they face a great tension between members of the family, high financial expenses, and difficulty communicating with their child. When the family views these stigmas as unmanageable, relationships weaken, and stress accumulates. The parent’s perception of their child’s uncontrollable selfish behavior causes them to believe there are disciplinary issues occurring. The common tendency for mothers who experience more elevated levels of stress due to their child’s illness is to view their behavior as deviant. A severely ill person will naturally have more difficulty suppressing their selfish desires, but this drives a wedge between them and their apathetic family members. Siblings of the sick become ‘forgotten’ by their parents and they too may lash out in attempts of receiving some attention. Elderly people are often diagnosed with chronic illnesses, making them even more aware of their numbered days. When most people hear the words ‘sick old people’ it can be quite obvious that they are the last thing anyone wants to be around. They are believed to be grouchy, rude, and miserable. And it is true, they are! Like many others that are chronically ill, older patients can try to put on the humble and serene faà §ade, but it won’t last very long. Nobody wants to be sick, and nobody wants to be in the presence of a sick person either. Why would anyone want that? People want to be able to make their own decisions without any restrictions. So, when chronic illness stands in the way of that ability, selfishness and impatience become very prominent. Okay I know this is where I am supposed to put my conclusion but it is very late and I really don’t feel like it so whoever is peer editing this if you wouldn’t mind putting down some things you feel as though I should include in this that would be GREAT thank you very much and I know my essay is a bit disorganized and my stance isn’t as clear as it could be but I will make it better it is just very late and my eyes are tired thanks so much. Ps also that’s not going to be my title lol I’m sorry I needed something to put there first thing that popped into my head alright bye

Health Care Communication Methods Essay

Every day in the health care field, professional have to choose the most effective communication method when communicating to other professionals, patients, patient families, and the general public. Different circumstances have very specific methods of communication that need to be utilized for communication to be effective. Furthermore, in the health care field the regulations of HIPAA have to be considered to ensure that certain information is being protected as well as identity of people pertaining to the health scenarios. Further will be discussed the methods of communicating in the health care field, the advantages and disadvantages of using traditional, electronic, and social media for health care communicating, and the effects of HIPAA and other regulations on the use of media in the health care field of communicating. Communication coordinators of any health care field have to decide often which methods of communication he or she would have to utilize and the rules and regulations that govern those methods. In one scenario, a communication coordinator that works for a national drug manufacturer has received report that there has been a report of significant negative side effects caused by one of the medications that is used by a large population of people and one including a well-known public figure. News reports having been reporting that of the possible individuals who have been taking this particular drug is effected by the side effects. The communication coordinator has to decide how to address the news reports and the general public about this situation. There are many different ways to communicate with the general public regarding the scenario described. As mentioned before the communication coordinator has to reach out to the general public regarding a medication that was distributed by a national drug manufacturer company that lead to significant side effects. Some of the different methods of communication using media are campaigns, medical journals, news reports, blogs, and other social medias. For the specific scenarios described previously it would be best to use the ampaign method. A campaign would be used to increase awareness, create a better understanding, modify attitude, and modify behavior (Health Industry Communication, Ch. 5). This method may be used when reaching out to a significant sized population. â€Å"The communication program will target whom, to help them understand, believe, or do what, by informing them of messages, through messengers and channels, to result in objectives† (Cheesebro, T. , O’Co nnor, L. , & Rios, F. , 2010, Ch. 5). The objective of utilizing the campaign method would reach out the larger population through possibly multiple different media methods, instead of just one or two. When considering using different types of media and which ones to include and exclude when communicating through media, it is important to consider the advantages and disadvantages of traditional, electronic, and social media. Traditional communication methods are the most common methods of communicating. This includes newspaper, journals, magazines, television, radio, and etc. While this might be considered one of the most effective methods compared to electronic and social media, there are disadvantages as well as advantages of traditional communication. One advantages of using traditional communication methods is this can reach a larger population which would then decrease the time it takes to reach the population by some other methods of communication. Another advantage of using traditional communication method is a larger part of the population uses this as resources to gain information for different point of interests. One disadvantage of using traditional communication methods is that it can be costly compared to some other communication methods. â€Å"Traditional medias have a high effect in creating awareness and influencing the attitude of the audience† (Tiwari, Singh, & Tiwari, 2003, p. 2). Electronic communication method also can be an effective way to communicate to the general public. Electronic communication includes email, phone calls, text messaging, video calling, and etc. Although not every method of electronic communication would be considered effective for scenario previously described, some such as email would assist with retrieving audience attention. Just like any other communication method, electronic communication method also has its advantages and disadvantages. An advantage of electronic communication method is it creates direct communication methods to the intended audiences which can begin to change audience attitude towards a circumstance before any other communication tactic takes into effect. One disadvantage of using electronic communication is there is a large section of the population that does not have access to electronics such as computers and internet. This population does not also have access to email and may not have easy access to a phone. Those people would then be more difficult to reach out to (Tiwari, Singh, & Tiwari, 2003). Another disadvantage may be the low literacy and language barrier of the population. Social media communication method is another way to communicate to the general public under different circumstances. Social media communication includes social sites such as Facebook, Twitter, online video sharing, podcasts, blogs, and etc. Although this may be an effective way to communicate to the public, there are advantages and disadvantages that come with social media communication. According to CDC (2011), † In the last several years, the use of Facebook, YouTube, Twitter and other social media tools to disseminate health messages has grown significantly, and continues to trend upward. Using social media tools has become an effective way to expand reach, foster engagement and increase access to credible, science-based health messages† (4). This also has an advantage because it reaches a larger population at a faster rate and costs less than some other methods of media communication. A disadvantage of using social media method in communication is the credibility of the resources may be still questioned by a large portion of the population. Another disadvantage of using social media communication is it may not reach all of the population to whom the topic is regarding. HIPAA plays a significant role in media communications. The essential functions of HIPAA regulations protect the privacy rights of patients and its users. When communicating health information, all health providers and any participants of health communication must ensure that the facts they wish to release are authorized and as accurate as possible (Nhanet, 2012). Any information released about any patients must be authorized by patients through written authorization and must follow federal and state guidelines. HIPAA prohibits any person communicating about health to public to disclose any information about patients even if it is general speaking of the patient. According to Hader and Brown (2010) â€Å"Healthcare providers using social media must remain mindful of professional boundaries and their patients’ privacy rights† (p. 1). In conclusion, communicating through different media methods can be a useful source to communicate effectively to the public. Some methods are better than other, however all methods have different advantages when communicating to the public. There are also many disadvantages that are to be considered when implementing each method. There are also HIPAA regulations that have to be followed when communicating about patients or to patients regarding any facts and issues. The media is a way to communicate to a significant sized population when HIPAA laws are followed.

Care Plan Chronic Heart Failure Health And Social Care Essay

The physician to population ratio grew from 2/1000 people in 2000 to 2.4/ 1000 people in merely a mere 5 years3. Despite the rapid growing, the ratio is still short as compared to other European states viz. France, Germany or Italy. This is worsened by the fact that the figure of patients treated in NHS infirmaries rose by 15 % at the same clip interval3. It is of import to use the expertness of other health care professionals, viz. community druggists, in support of the increasing figure of patients in the community in order to better patient attention. The World Health Organization defines chronic complaints to be ‘a wellness job necessitating on-going direction over a period of old ages or decennaries ‘ . NHS Scotland has identified that chronic unwellness is farther complicated by demographical alterations, increasing co-morbidities, widening spread of wellness inequalities and the increased outlooks placed on the health care system4. Actions have been taken to promote modernisation of NHS community pharmaceutics in Scotland. The debut of the New Pharmacy Contract was the action program from the Scottish Executive ‘s scheme papers ‘The Right Medicine ‘ in which nucleus pharmaceutical attention services such as Chronic Medication Service ( CMS ) , Minor Ailments Service ( MAS ) , Acute Medication Service ( AMS ) and Public Health Service were designed to optimise the use of community druggist ‘s accomplishments to widen the range and farther better the quality of attention proviso to patients5. The contract was driven by a quotation mark by the World Health Organization ( WHO ) in 2002, adverting that reacting to the demands to patients with chronic conditions post the biggest challenge to wellness systems around the globe4. The foundation of the CMS is built upon the cardinal countries: patient centered ; clinical administration ; collaborative working ; support for execution ; monitoring and reappraisal and service development6. The nucleus aims of CMS are summarized in Appendix 1. The altering function of the druggist is in response to the increasing demand for betterment in patient ‘s medicines direction. The debut of the CMS is to further develop the parts of the community druggist to guarantee the continuity of pharmaceutical attention in patients with long-run conditions every bit good as cementing the stature of community druggists in the NHS4. Pharmaceutical attention is an effectual tool in the direction of chronic complaints and is defined as the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life harmonizing to Hepler and Strand7. Pharmaceutical attention is hence a collaborative attempt between healthcare professionals endeavoring to better drug therapy direction via uninterrupted monitoring of inauspicious effects, effectivity and patient instruction all meeting to better patient ‘s quality of life8. Healthcare professionals play a critical function in autho rising patients to take charge of their ain wellness, as this would ease them in accomplishing their coveted quality of life relevant to their wellness believes6. Community druggist can be the accelerator in smoothing the patient ‘s journey of attention by being the gateway of information via improved entree to healthcare services and to back up self-care6. It is simple to merely purchase a battalion of medicine over the counter to handle an false unwellness but the bulk is incognizant of the possible injury it presents. Some might non take earnestly an overdose of medicines that have a broad curative index but for drugs that have a narrow curative index, a simple overdose could be fatal. There is merely so much a prescriber could make but hanker term attending is indispensable to guarantee that patients get the best out of their medicine particularly in those who have multiple co-morbidities. The attack of CMS is through the constitution of curative partnerships between general medical practicians, druggists and patients to better patient attention by guaranting better local entree to wellness care6. Fostering such commitment will minimise duplicate of functions and, with good defined functions, can advance a holistic attack to the pharmaceutical and clinical attention of patients6. The end is to assist patients harvest the most out of their medical specialties but besides minimise any associated risks4. Community druggist is frequently the first and lone point of call. Community druggists can bridge the spread in a patient ‘s journey of attention and therefore better the whole curative class by expecting, placing, deciding and forestalling medicine-related issues4,9. These medicine-related issues include: Safety and efficaciousness Side effects Conformity and harmony Identify markers of hapless control Symptom specific markers to motivate referral Supplying and advancing wellness information and instruction CMS is a service that requires patients ‘ voluntary engagement and is by and large broken down into 3 phases. Phase 1 involves the enrollment of the patient for the service. Stage 2 involves the debut of a generic model for pharmaceutical attention planning. Phase 3 is the constitution of the shared attention component between the GP and the community pharmacist6. A pharmaceutical attention program paperss the patient ‘s pharmaceutical attention demands, attention issues, desired results and actions required as portion of the pharmaceutical attention planning of the patient. Figure 1 summarizes the pharmaceutical attention be aftering rhythm. Identify and prioritise patients with pharmaceutical attention demands Identify and reexamine pharmaceutical attention issues Implement and proctor pharmaceutical attention program Formulate and document a pharmaceutical attention program Figure 1: Pharmaceutical Care Planning Cycle To get down of with attention planning, critical information that may act upon the attention program such as patient ‘s general wellness, allergic reactions or sensitivenesss, other medical conditions and hazard factors are noted. A hazard appraisal is so made to help the druggist in placing and prioritising any pharmaceutical attention needs that a patient might necessitate or is deprived from in footings of service, which as a consequence influences the therapy6. Next, an appraisal is made to place and reexamine the patients pharmaceutical attention demands and refering issues. This can enable the druggist to measure the medical specialties regimen that a patient is on in footings of efficaciousness or toxicity profile and besides allows the druggist to measure how deep the patients understand their medicines and intervention and the extend of their wellness believes. Subsequently, a pharmaceutical attention program is drafted based on the attention issues that have been iden tified with the understanding of the patient. This attention program serves as a protocol in which issues are placed on a hierarchy of precedence, outcome ends are defined, proposals to any class of action documented every bit good as clearly specifying the health care forces and their duties for assorted monitoring that ought to be conducted. Changeless reappraisals and monitoring is done to measure the results of the attention program upon execution and alterations are made along the manner, when required, to maximise the curative result. To accomplish the maximal curative benefit, the patient ‘s wellness belief and apprehension of the therapy is indispensable. Hence, reding and advice by the druggist before, during and after the procedure is good. Chronic Heart Failure ( CHF ) is one of the 13 long-run disease provinces covered in the CMS protocol stand foring the most frequent indicant for therapy4. The list of all 13 disease provinces are listed in Appendix 2. Heart Failure is one of the most crippling medical conditions which can badly impact a patient ‘s quality of life hence seting force per unit area on hospitalization and health care budgets10. The Scots Intercollegiate Guidelines Network ( SIGN ) defines CHF as a complex clinical syndrome ensuing from any structural/ functional upset that impairs the ability of the bosom to react to physiological demands for increased cardiac output11. Hence, bringing of blood is compromised12. Abnormality in cardiac construction, beat, map or conductivity can all take to unequal perfusion, venous congestion and disturbed H2O and electrolyte balance that underlie CHF13. In add-on, normal compensatory mechanisms become compromised taking to maladaptive secondary physiological effe cts that contribute to the progressive nature of the disease12. CHF can be a effect of assorted underlying complications such as myocardial infarction and/or high blood pressure and the most common being left ventricular systolic disfunction ( LVSD ) . Coronary arteria disease, aortal stricture, dilated myocardiopathy, alcoholic myocardiopathy, Chagas ‘ disease, endomyocardial fibrosis and other mechanical defects such as cardiac valvular disfunction, degenerative valve disease, arthritic valve disease, terrible anaemia and thyrotoxicosis are the more common causes of CHF around the Earth but other rarer causes do exist12,13. Management of these predisposing factors can be good in relieving the symptoms of bosom failure. Table 1 is the New York Heart Association ( NYHA ) categorization system used to sort patients with bosom failure based on their functional position. Table 2 is ACC /AHA phases of HF ; a addendum to the NYHA categorization. It is estimated that there is a prevalence of about 1-2 % for bosom failure in developed countries10,14. The life-time hazard of developing HF is approximately 20 % for patients above 40 old ages old and besides the taking cause of hospitalization for patients above 65 old ages old10,14. Harmonizing to the European Society of Cardiology, above 15 million patients are diagnosed with HF in 51 European states consisting a population of around 900 million15. The prevalence of HF is about 1-2 % in the western society and the incidences are between 5-10/ 1000 instances per annum16. A recent US population-based survey, the prevalence of bosom failure was 2.2 % ( 95 CI 1.6 % to 2.8 % ) , increasing from 0.7 % in individuals aged 45 through 54 old ages to 8.4 % for those aged 75 old ages or older17. Similar minor expense forms, 1 % for the 55-64 age group increasing to 13 % in the 75-84 age group was observed from the Rotterdam study18. In the contrary, for the below 50 age group, incidences of HF are rare16. Improved endurance from acute myocardial infarction ( MI ) coupled with the aging population contributes to the spike in incidence and prevalence of HF19. One critical function community pharmacist drama is to advice and offer guidance on a healthy life style. Lifestyle and dietetic alterations are schemes aimed at forestalling cardiovascular diseases ( CVD ) which are possible predisposing factors taking to CHF. The development of CVD is affected by multiple dietetic factors and an overall healthy diet will significantly cut down the hazard of CVD20. Consumption of fruits, veggies, grain merchandises, low-fat dairy merchandises and curtailing the sum of salt and unstable consumption are all portion of a well balanced diet11,21. Keeping a healthy organic structure weight is indispensable as fleshiness is an independent hazard factor for CVD. Morbid fleshiness has a strong association with mortality from CVD particularly in immature grownup males. Therefore, bar of fleshiness has to be taken early and in an aggressive manner22. Keeping optimum blood force per unit area, blood glucose every bit good as a desirable lipid profile is advise d to command or lower the hazard of CVD21. Maintaining physical and cardiovascular fittingness and a healthy weight can be achieved by changeless physical activities as it improves cardiovascular hazard factors every bit good as take downing the hazard of developing other chronic diseases21,23. Evidence has proven the strong association between smoking and cardiovascular jeopardies every bit good as the benefits of smoking cessation24. Therefore, look intoing the smoke position of patients and offering intercession where appropriate will be good to patients peculiarly in those who are at hazard of enduring from cardiovascular events24. Patients with CHF should be advised to discontinue smoking11. Moderate ingestion of intoxicant should besides be advised as extra alcohol ingestion can increase the hazard of CVD11,25. The above are merely the chief life style and dietetic parametric quantities that should be addressed with precedence to command or lower CVD hazards. Such steps should non be seen as stairss taken to forestall CVD but instead as stairss taken to promote everybody to populate a healthy life style to forestall any signifier of disease provinces. Psychosocial and psychological hurt have a important impact in morbidity and mortality after HF and hence societal and relationship factors may play an of import function in pull offing chronic conditions such as CHF26. The ends of intervention are to better quality of life11,13. Angiotensin Converting Enzyme Inhibitors ( ACEi ) Evidence has shown that ACEi therapy is good in take downing mortality, MI and rehospitalization for patients enduring from HF with LVD or HF with or without a recent MI27. A meta-analysis has shown that patients with CHF prescribed with an ACEi have a 23 % decrease in mortality and a 35 % decrease in rehospitalization27. Further meta-analysis is patients with LVSD, HF or both after MI has a comparative decrease in mortality rate of 26 % 27. Therefore, ACEi therapy is recommended in patients with all NYHA functional categories of HF due to LVSD11. Adverse effects include cough, hypotension, nephritic damage, angio-oedema and hyperkaelaemia. Dose titration and nephritic and electrolyte monitoring should be included in the attention program particularly in susceptible patients utilizing other medicines so that intercession could be established in instances where inauspicious effects are marked. Beta Blockers Treatment with bisoprolol, carvedilol and Lopressor Forty shows a decrease in mortality in patients with advanced HF based on the CIBIS- II, COPERNICUS, and MERIT-HF tests severally. Beta-blockers benefits in HF by demoing a 29 % decrease in hazard of mortality in CVD, 36 % decrease due to pump failure and all cause mortality decrease of 23 % 28. All patients with HF due to LVSD of all NYHA functional category should be started on beta-blockers every bit shortly as their status is stable and should be the first line picks for patients with CHF due to LVSD11. The effects of beta-blockers might non be seen instantly. Furthermore, deterioration of HF and hypotension might be present at the get downing hence dose should be titrated up suitably upon supervising. Beta-blockers are contraindicated in those with asthma, bronchospasm, 2nd or 3rd degree auriculoventricular bosom block or diagnostic hypotension11. Angiotensin II Receptor Blocker ( ARB ) ARBs antagonizes the binding of angiotonin II to its type 1 receptor hence exercising its action similar to ACEi ‘s with the benefit of non bring forthing dry cough as a side effect13. In CHARM Alternative, ARB intervention led to a comparative decrease of 23 % in primary result of CV deceases or rehospitalsation for patients with CHF having candesartan who are intolerant to ACEi29. The add-on of ARB to ACEi or beta-blocker intervention non merely had no consequence on mortality but markedly reduced HF rehospitalisation and mortality combined30. Patients with CHF due to LVSD, HF or LVSD or both station MI who are intolerant to ACEi should be considered for ARBs whilst patients with HF due to LVSD who are still diagnostic despite already on ACEi and beta-blockers, add-on of candesartan might be beneficial11. Aldosterone Adversaries Aldosterone adversary has been studied in patients with terrible diagnostic HF, led to a pronounced decrease in mortality and morbidity and improved symptoms13,31. It is recommended for patients with HF in NYHA category III and IV despite being on ACEi and beta-blocker while there is no grounds that Aldactone has any benefits in mild HF11,13. The RALES test has shown that the add-on of Aldactone to an ACEi yielded an all cause mortality of 30 % and cardiac mortality by 31 % 31. However, aldosterone adversaries produce many inauspicious effects on vascular map and myocardial fibrosis11. Spironolactone produces gynaecomastia, hyperkaelaemia, and nephritic disfunction hence blood carbamide, creatinine and electrolyte monitoring is essential11. Patients with terrible HF due to LVSD should be on Aldactone unless contraindicated11. Eplerenone can be used if patients are intolerant to spironolactone as grounds from EPHESUS survey has demonstrated a 13 % decrease from CVD or hospitalization for CVD and 21 % comparative rate of sudden decease in patients on eplerenone32. Diuretic drugs Fluid keeping doing ankle hydrops, pneumonic hydrops or both consequences in symptoms of dyspnea in most patients enduring from HF11. A meta-analysis supports that diuretic therapy is good for patients with dyspnea or hydrops with a 75 % decrease in mortality and 63 % betterment in exercising capacity33. The hazard of loop water pills doing hypokalaemia is offset by ACEi, ARBs and Aldactone. Therefore, monitoring of serum K is of import. Doses of water pills should be individualized to minimise unstable keeping taking into history the possibility of desiccation and nephritic impairments11. Digoxin In a Cochrane reappraisal, patients on Lanoxin showed a 64 % betterment in symptoms and a 23 % decrease in hospitalization but unluckily no betterment seen on survival34. Digoxin should be considered as an accessory therapy for instances in which patients with HF in fistula beat are non relieved on optimal therapy11. There are many issues associated with the usage of Lanoxin because of its narrow curative index, some of which are fatal such as its ability to increase the possibility of sudden decease and the hazard of toxicity in instance of hypokalaemia11. Therefore, the hazard over benefit of Lanoxin therapy should be carefully considered in the best involvement of the patient. Care Plan Chronic Heart Failure Health And Social Care Essay The physician to population ratio grew from 2/1000 people in 2000 to 2.4/ 1000 people in merely a mere 5 years3. Despite the rapid growing, the ratio is still short as compared to other European states viz. France, Germany or Italy. This is worsened by the fact that the figure of patients treated in NHS infirmaries rose by 15 % at the same clip interval3. It is of import to use the expertness of other health care professionals, viz. community druggists, in support of the increasing figure of patients in the community in order to better patient attention. The World Health Organization defines chronic complaints to be ‘a wellness job necessitating on-going direction over a period of old ages or decennaries ‘ . NHS Scotland has identified that chronic unwellness is farther complicated by demographical alterations, increasing co-morbidities, widening spread of wellness inequalities and the increased outlooks placed on the health care system4. Actions have been taken to promote modernisation of NHS community pharmaceutics in Scotland. The debut of the New Pharmacy Contract was the action program from the Scottish Executive ‘s scheme papers ‘The Right Medicine ‘ in which nucleus pharmaceutical attention services such as Chronic Medication Service ( CMS ) , Minor Ailments Service ( MAS ) , Acute Medication Service ( AMS ) and Public Health Service were designed to optimise the use of community druggist ‘s accomplishments to widen the range and farther better the quality of attention proviso to patients5. The contract was driven by a quotation mark by the World Health Organization ( WHO ) in 2002, adverting that reacting to the demands to patients with chronic conditions post the biggest challenge to wellness systems around the globe4. The foundation of the CMS is built upon the cardinal countries: patient centered ; clinical administration ; collaborative working ; support for execution ; monitoring and reappraisal and service development6. The nucleus aims of CMS are summarized in Appendix 1. The altering function of the druggist is in response to the increasing demand for betterment in patient ‘s medicines direction. The debut of the CMS is to further develop the parts of the community druggist to guarantee the continuity of pharmaceutical attention in patients with long-run conditions every bit good as cementing the stature of community druggists in the NHS4. Pharmaceutical attention is an effectual tool in the direction of chronic complaints and is defined as the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life harmonizing to Hepler and Strand7. Pharmaceutical attention is hence a collaborative attempt between healthcare professionals endeavoring to better drug therapy direction via uninterrupted monitoring of inauspicious effects, effectivity and patient instruction all meeting to better patient ‘s quality of life8. Healthcare professionals play a critical function in autho rising patients to take charge of their ain wellness, as this would ease them in accomplishing their coveted quality of life relevant to their wellness believes6. Community druggist can be the accelerator in smoothing the patient ‘s journey of attention by being the gateway of information via improved entree to healthcare services and to back up self-care6. It is simple to merely purchase a battalion of medicine over the counter to handle an false unwellness but the bulk is incognizant of the possible injury it presents. Some might non take earnestly an overdose of medicines that have a broad curative index but for drugs that have a narrow curative index, a simple overdose could be fatal. There is merely so much a prescriber could make but hanker term attending is indispensable to guarantee that patients get the best out of their medicine particularly in those who have multiple co-morbidities. The attack of CMS is through the constitution of curative partnerships between general medical practicians, druggists and patients to better patient attention by guaranting better local entree to wellness care6. Fostering such commitment will minimise duplicate of functions and, with good defined functions, can advance a holistic attack to the pharmaceutical and clinical attention of patients6. The end is to assist patients harvest the most out of their medical specialties but besides minimise any associated risks4. Community druggist is frequently the first and lone point of call. Community druggists can bridge the spread in a patient ‘s journey of attention and therefore better the whole curative class by expecting, placing, deciding and forestalling medicine-related issues4,9. These medicine-related issues include: Safety and efficaciousness Side effects Conformity and harmony Identify markers of hapless control Symptom specific markers to motivate referral Supplying and advancing wellness information and instruction CMS is a service that requires patients ‘ voluntary engagement and is by and large broken down into 3 phases. Phase 1 involves the enrollment of the patient for the service. Stage 2 involves the debut of a generic model for pharmaceutical attention planning. Phase 3 is the constitution of the shared attention component between the GP and the community pharmacist6. A pharmaceutical attention program paperss the patient ‘s pharmaceutical attention demands, attention issues, desired results and actions required as portion of the pharmaceutical attention planning of the patient. Figure 1 summarizes the pharmaceutical attention be aftering rhythm. Identify and prioritise patients with pharmaceutical attention demands Identify and reexamine pharmaceutical attention issues Implement and proctor pharmaceutical attention program Formulate and document a pharmaceutical attention program Figure 1: Pharmaceutical Care Planning Cycle To get down of with attention planning, critical information that may act upon the attention program such as patient ‘s general wellness, allergic reactions or sensitivenesss, other medical conditions and hazard factors are noted. A hazard appraisal is so made to help the druggist in placing and prioritising any pharmaceutical attention needs that a patient might necessitate or is deprived from in footings of service, which as a consequence influences the therapy6. Next, an appraisal is made to place and reexamine the patients pharmaceutical attention demands and refering issues. This can enable the druggist to measure the medical specialties regimen that a patient is on in footings of efficaciousness or toxicity profile and besides allows the druggist to measure how deep the patients understand their medicines and intervention and the extend of their wellness believes. Subsequently, a pharmaceutical attention program is drafted based on the attention issues that have been iden tified with the understanding of the patient. This attention program serves as a protocol in which issues are placed on a hierarchy of precedence, outcome ends are defined, proposals to any class of action documented every bit good as clearly specifying the health care forces and their duties for assorted monitoring that ought to be conducted. Changeless reappraisals and monitoring is done to measure the results of the attention program upon execution and alterations are made along the manner, when required, to maximise the curative result. To accomplish the maximal curative benefit, the patient ‘s wellness belief and apprehension of the therapy is indispensable. Hence, reding and advice by the druggist before, during and after the procedure is good. Chronic Heart Failure ( CHF ) is one of the 13 long-run disease provinces covered in the CMS protocol stand foring the most frequent indicant for therapy4. The list of all 13 disease provinces are listed in Appendix 2. Heart Failure is one of the most crippling medical conditions which can badly impact a patient ‘s quality of life hence seting force per unit area on hospitalization and health care budgets10. The Scots Intercollegiate Guidelines Network ( SIGN ) defines CHF as a complex clinical syndrome ensuing from any structural/ functional upset that impairs the ability of the bosom to react to physiological demands for increased cardiac output11. Hence, bringing of blood is compromised12. Abnormality in cardiac construction, beat, map or conductivity can all take to unequal perfusion, venous congestion and disturbed H2O and electrolyte balance that underlie CHF13. In add-on, normal compensatory mechanisms become compromised taking to maladaptive secondary physiological effe cts that contribute to the progressive nature of the disease12. CHF can be a effect of assorted underlying complications such as myocardial infarction and/or high blood pressure and the most common being left ventricular systolic disfunction ( LVSD ) . Coronary arteria disease, aortal stricture, dilated myocardiopathy, alcoholic myocardiopathy, Chagas ‘ disease, endomyocardial fibrosis and other mechanical defects such as cardiac valvular disfunction, degenerative valve disease, arthritic valve disease, terrible anaemia and thyrotoxicosis are the more common causes of CHF around the Earth but other rarer causes do exist12,13. Management of these predisposing factors can be good in relieving the symptoms of bosom failure. Table 1 is the New York Heart Association ( NYHA ) categorization system used to sort patients with bosom failure based on their functional position. Table 2 is ACC /AHA phases of HF ; a addendum to the NYHA categorization. It is estimated that there is a prevalence of about 1-2 % for bosom failure in developed countries10,14. The life-time hazard of developing HF is approximately 20 % for patients above 40 old ages old and besides the taking cause of hospitalization for patients above 65 old ages old10,14. Harmonizing to the European Society of Cardiology, above 15 million patients are diagnosed with HF in 51 European states consisting a population of around 900 million15. The prevalence of HF is about 1-2 % in the western society and the incidences are between 5-10/ 1000 instances per annum16. A recent US population-based survey, the prevalence of bosom failure was 2.2 % ( 95 CI 1.6 % to 2.8 % ) , increasing from 0.7 % in individuals aged 45 through 54 old ages to 8.4 % for those aged 75 old ages or older17. Similar minor expense forms, 1 % for the 55-64 age group increasing to 13 % in the 75-84 age group was observed from the Rotterdam study18. In the contrary, for the below 50 age group, incidences of HF are rare16. Improved endurance from acute myocardial infarction ( MI ) coupled with the aging population contributes to the spike in incidence and prevalence of HF19. One critical function community pharmacist drama is to advice and offer guidance on a healthy life style. Lifestyle and dietetic alterations are schemes aimed at forestalling cardiovascular diseases ( CVD ) which are possible predisposing factors taking to CHF. The development of CVD is affected by multiple dietetic factors and an overall healthy diet will significantly cut down the hazard of CVD20. Consumption of fruits, veggies, grain merchandises, low-fat dairy merchandises and curtailing the sum of salt and unstable consumption are all portion of a well balanced diet11,21. Keeping a healthy organic structure weight is indispensable as fleshiness is an independent hazard factor for CVD. Morbid fleshiness has a strong association with mortality from CVD particularly in immature grownup males. Therefore, bar of fleshiness has to be taken early and in an aggressive manner22. Keeping optimum blood force per unit area, blood glucose every bit good as a desirable lipid profile is advise d to command or lower the hazard of CVD21. Maintaining physical and cardiovascular fittingness and a healthy weight can be achieved by changeless physical activities as it improves cardiovascular hazard factors every bit good as take downing the hazard of developing other chronic diseases21,23. Evidence has proven the strong association between smoking and cardiovascular jeopardies every bit good as the benefits of smoking cessation24. Therefore, look intoing the smoke position of patients and offering intercession where appropriate will be good to patients peculiarly in those who are at hazard of enduring from cardiovascular events24. Patients with CHF should be advised to discontinue smoking11. Moderate ingestion of intoxicant should besides be advised as extra alcohol ingestion can increase the hazard of CVD11,25. The above are merely the chief life style and dietetic parametric quantities that should be addressed with precedence to command or lower CVD hazards. Such steps should non be seen as stairss taken to forestall CVD but instead as stairss taken to promote everybody to populate a healthy life style to forestall any signifier of disease provinces. Psychosocial and psychological hurt have a important impact in morbidity and mortality after HF and hence societal and relationship factors may play an of import function in pull offing chronic conditions such as CHF26. The ends of intervention are to better quality of life11,13. Angiotensin Converting Enzyme Inhibitors ( ACEi ) Evidence has shown that ACEi therapy is good in take downing mortality, MI and rehospitalization for patients enduring from HF with LVD or HF with or without a recent MI27. A meta-analysis has shown that patients with CHF prescribed with an ACEi have a 23 % decrease in mortality and a 35 % decrease in rehospitalization27. Further meta-analysis is patients with LVSD, HF or both after MI has a comparative decrease in mortality rate of 26 % 27. Therefore, ACEi therapy is recommended in patients with all NYHA functional categories of HF due to LVSD11. Adverse effects include cough, hypotension, nephritic damage, angio-oedema and hyperkaelaemia. Dose titration and nephritic and electrolyte monitoring should be included in the attention program particularly in susceptible patients utilizing other medicines so that intercession could be established in instances where inauspicious effects are marked. Beta Blockers Treatment with bisoprolol, carvedilol and Lopressor Forty shows a decrease in mortality in patients with advanced HF based on the CIBIS- II, COPERNICUS, and MERIT-HF tests severally. Beta-blockers benefits in HF by demoing a 29 % decrease in hazard of mortality in CVD, 36 % decrease due to pump failure and all cause mortality decrease of 23 % 28. All patients with HF due to LVSD of all NYHA functional category should be started on beta-blockers every bit shortly as their status is stable and should be the first line picks for patients with CHF due to LVSD11. The effects of beta-blockers might non be seen instantly. Furthermore, deterioration of HF and hypotension might be present at the get downing hence dose should be titrated up suitably upon supervising. Beta-blockers are contraindicated in those with asthma, bronchospasm, 2nd or 3rd degree auriculoventricular bosom block or diagnostic hypotension11. Angiotensin II Receptor Blocker ( ARB ) ARBs antagonizes the binding of angiotonin II to its type 1 receptor hence exercising its action similar to ACEi ‘s with the benefit of non bring forthing dry cough as a side effect13. In CHARM Alternative, ARB intervention led to a comparative decrease of 23 % in primary result of CV deceases or rehospitalsation for patients with CHF having candesartan who are intolerant to ACEi29. The add-on of ARB to ACEi or beta-blocker intervention non merely had no consequence on mortality but markedly reduced HF rehospitalisation and mortality combined30. Patients with CHF due to LVSD, HF or LVSD or both station MI who are intolerant to ACEi should be considered for ARBs whilst patients with HF due to LVSD who are still diagnostic despite already on ACEi and beta-blockers, add-on of candesartan might be beneficial11. Aldosterone Adversaries Aldosterone adversary has been studied in patients with terrible diagnostic HF, led to a pronounced decrease in mortality and morbidity and improved symptoms13,31. It is recommended for patients with HF in NYHA category III and IV despite being on ACEi and beta-blocker while there is no grounds that Aldactone has any benefits in mild HF11,13. The RALES test has shown that the add-on of Aldactone to an ACEi yielded an all cause mortality of 30 % and cardiac mortality by 31 % 31. However, aldosterone adversaries produce many inauspicious effects on vascular map and myocardial fibrosis11. Spironolactone produces gynaecomastia, hyperkaelaemia, and nephritic disfunction hence blood carbamide, creatinine and electrolyte monitoring is essential11. Patients with terrible HF due to LVSD should be on Aldactone unless contraindicated11. Eplerenone can be used if patients are intolerant to spironolactone as grounds from EPHESUS survey has demonstrated a 13 % decrease from CVD or hospitalization for CVD and 21 % comparative rate of sudden decease in patients on eplerenone32. Diuretic drugs Fluid keeping doing ankle hydrops, pneumonic hydrops or both consequences in symptoms of dyspnea in most patients enduring from HF11. A meta-analysis supports that diuretic therapy is good for patients with dyspnea or hydrops with a 75 % decrease in mortality and 63 % betterment in exercising capacity33. The hazard of loop water pills doing hypokalaemia is offset by ACEi, ARBs and Aldactone. Therefore, monitoring of serum K is of import. Doses of water pills should be individualized to minimise unstable keeping taking into history the possibility of desiccation and nephritic impairments11. Digoxin In a Cochrane reappraisal, patients on Lanoxin showed a 64 % betterment in symptoms and a 23 % decrease in hospitalization but unluckily no betterment seen on survival34. Digoxin should be considered as an accessory therapy for instances in which patients with HF in fistula beat are non relieved on optimal therapy11. There are many issues associated with the usage of Lanoxin because of its narrow curative index, some of which are fatal such as its ability to increase the possibility of sudden decease and the hazard of toxicity in instance of hypokalaemia11. Therefore, the hazard over benefit of Lanoxin therapy should be carefully considered in the best involvement of the patient.

Second-Hand Smokers and Harmful Effects on People from All Ages Research Paper - 1

Second-Hand Smokers and Harmful Effects on People from All Ages - Research Paper Example Second-hand smoking as the health departments put it, apart from causing diseases also worsens the already existing health conditions. This conditions that may worsen from inhaling smoke from cigarettes and even marijuana include asthma, pneumonia, heart disease, and even bronchitis. For those getting exposure to this smoke in longer terms face the problem of developing, fatal, and chronic heart diseases. On the other hand, brief exposure cause health problems such as stuffy nose, headaches, irritation of the eyes and sinuses, coughing, headaches, and even triggering heart or breathing problems. The heart problems arise from the fact that the smoke from the cigarettes makes blood thicker, thus raising the level of "bad cholesterol" and damages the lining of one's blood vessel, this in turn results to heart problems, heart attacks, and eventually death. This smoke is even worse when it comes to pregnant women, children and even babies, when pregnant women inhale this smoke the effect mainly goes to the babies, the most likely scenario, in this case, is underweight babies, development of pneumonia, ear infections, and even ‘sudden infant death syndrome.' Medical practitioners state that children are often at a greater risk than the adults are; this is because their bodies are still on the growth stage thus they tend to breathe more than the adults do. Second-hand smoking causes chronic coughing and wheezing, ear infections, severe and frequent asthma attack, and lower respiratory illnesses.

Organisational Politics Dissertation Example | Topics and Well Written Essays - 10750 words

Organisational Politics - Dissertation Example In the highly competitive environment, where every individual is concerned about job security, pursuance of self-interest has taken dominance. Managers engage in enhancing their abilities and capabilities to use power, and participate in political activities. In the process, they attempt to exercise coercion and control over their subordinates. This naturally gives rise to resistance which takes the shape of conflicts. However, according to Max Weber, organizations can achieve the coordination necessary for rational, logical and calculable action only through impersonal coercion and discipline of subordinates and clients (McNeill, 1978, p65). Pfeffer (1992, p10) contends that power and influence are social realities and in trying to ignore them, organizations lose a chance to understand these critical social processes and to train managers to cope with them. However, power has been associated with such a negative interpretation that people keep away from it for fear of getting a bad name. Politics in general is also related to negative outcomes; politics is considered to be inherently non-rational and subject to power interactions between diverse interests (Kinicki, 2008) but Vigoda (2000, p1) found weak negative relationship between perception of organizational politics and employees’ performance. ... Allen et al (1978, p78) emphasize that managers must know of the political processes and elaborate on the proactive and reactive behavior of the managers. Lee (1987, p316) identifies sources of power as coalition, expertise, information, rewards, emotional ties, authority and coercion while Varman and Bhatnagar add formal authority, rules and regulations, knowledge and information, counter organizations and informal organizations. However, a person’s actual power is a function of the sources, importance and scarcity of the power available to them (Lee, 1987, p317). Farrell and Peterson (1982, p403) examine individual political behavior within an organization, which they feel has been neglected. Fleming and Spicer (2008, p302) propose that power and resistance in an organization are intertwined. Bureaucratic power is used to exercise control and this gives rise to conflicts in the organization. Thompson (1960, p390) discusses the different forms and sources of organizational co nflicts while Rubenstein (1996) differentiates between conflict management, conflict resolution and conflict settlement. To resolve conflicts power and politics are the facilitators. Most of the literature reviewed here suggests that people are rational and active in pursuit of their goals. They need to influence, they need to manipulate to accomplish goals. This would imply that using tact and manipulation is acceptable as it helps further the interest of the individual as well as of the organization. However, they are seldom conscious of the repercussions of their actions. Imbalance of power can lead to several undesirable consequences such as workplace bullying, harassment and victimization. Several authors such as

Surface Plasmon Resonance Sensors Term Paper Example | Topics and Well Written Essays - 2500 words

Surface Plasmon Resonance Sensors - Term Paper Example The metals used are mainly gold and silver. When the surface plasmons collide with light energy, a kind of resonance occurs named; surface Plasmon polarization. The resonance continues oscillating along the surface of the metal decaying gradually through loss of energy to the absorption into the metal and radiation to the media interface i.e. air or water or other surface (Bozhevolnyi, 2008). The resonance of the surface Plasmon is then used to monitor the reflected light energy from a prism coupler in relation to the angle of incidence. This method can be applied to solve real life problems like observation of nanometer variations in density, thickness and molecular adsorption. Devices are being innovated every day in application of this technique. The surface Plasmon resonance sensors (SPRS) help detect chemicals, molecules, tissues like proteins, metals among other materials. This technology has been commercialized hence it is used in a very wide number of fields i.e. mass destruc tion weapons, medicine, security protocols, pharmacy, production plants, service delivery like water for residential use, optic communications and so on (Thirstrup, 2004). New and Useful Applications of Surface Plasmon Resonance Sensors The applications could be classified into four distinct groups: 1. Optical sensors 2. Biosensors 3. Chemical sensor Optical Sensors The most influential application of this technology was in the fiber optic. In this type of sensors, data is converted into light energy and interfaced with a dielectric metal. The high refractive index of the metal allows for total internal refraction thus the light energy is infinitely refracted along the cable with minimum loss of energy. This excites the surface Plasmons thus creating a surface resonance wave. The fiber optic cable is designed with a core metal in the centre, a bimetallic surround to the inner metal, a protective layer of metal preventing the effect of external waves to the wave in transit and insula tors all around each layer. When a light is beamed on a prism at an angle greater than the critical angle of the media, total internal reflection occurs. The wave formed in the media could be manipulated through the use of a material with a higher di-electric constant. This could be regulated to match the surface Plasmon resonance. It in turn creates a wave that travels along the surface of the metal at very high speeds. The energy formed through conversion of light energy to electronic energy can be controlled to achieve optimum sensor values i.e. increasing the two main parameters: sensitivity and signal-to-noise ratio. The sensor can be improved by using a dielectric media with a high refractive index. However, the materials used are limited to costs thus a balance needs to be maintained between the two (Wang, 2002). Figure 1: prism experiment of the surface Plasmon wave Biosensors These are devices used to analyze the detection of analytes that combine physiochemical detector co mponent with biological components e.g. tissues, molecules, fluids and so on. This technology takes advantage of the application of surface Plasmon resonance sensors at the molecular level. This is technically used to identify various types of molecules based on the level of excitement induced by a photon of light incident on the molecules of the object in test. The biosensors are used to perform rather difficult tests i.e. testing the Ph of the brain, the Ph of the eye, the Ph under the skin and so on. The

Are different patterns of communication in men and women Innately Essay

Are different patterns of communication in men and women Innately different - Essay Example The genetics of men and of women differ, in the same way; their brains perceive their communication thus the exhibition of different communication patterns between them. The different patterns are explained by various factors which are intertwined with the genetics of the respective gender in ways such as. The men are there to listen much and not to talk much while the women talk much and listen less, the men listen with a goal to achieve a solution at the end while women talk to heard and not necessarily to achieve a solution to a problem. The men usually compartmentalize their issues when it comes to communicating while women uses the big picture, this means that a man can be able to separate issues relating to different aspects of their lives as they communicate while women cannot be able to separate them. In other words, they use all the small chunks of information, from family, to relationships and to work and they speak about them, another pattern that can be observed in the co mmunication patterns are that women talk so much in a given period while men actually speak so little (Gray, 2015). All these variations in the communication patterns are innate in that the men can hardly adjust and the women can also hardly adjust. Neuroscience has gone a great way to try and explain the innateness of the communication patterns in the men and women to this date. First, the neuroscientists and researchers have assumed two aspects which are innate and can affect the communication patterns of men as well as of women. These factors includes the larynx which is a biological anatomical organ of the human body and the second one which can explain the observed difference is the corpus callosum in the brain of these subjects (University of Pennyslavia, 2010). To begin with, the larynx is a part for the body in the throat which affects the patterns of communication. This is an

Aspects of Corporate Financial Policy Essay Example | Topics and Well Written Essays - 3500 words

Aspects of Corporate Financial Policy - Essay Example The view that dividend does not matter as far as wealth maximization is concerned has its support in the article by Miller (n.d.) entitled â€Å" Do Dividends Really Matter?† In said paper, Miller explained his position about the few aspects of corporate financial policy where academics and practitioners differ on what really is the effect of dividend policy on stock price. He is aware that the academic consensus that dividends do not matter much and that the market should not be expected to increase prices because of â€Å"generous† dividend policies. He, however, admits that generous dividends may cause share to sell lower due to tax penalties or higher taxes on dividends as against capital gains. On the other hand, he also knows of the continued claims from corporate officials and investment bankers about the big influence of dividend on market prices because of cited instance where there were jumps in price after some announcements of resumption of regular dividends (Miller, n.d.).One may easily notice what caused the world of academicians to differ from those of practitioners. It may be asserted the academicians seem to view things from a long-term point of view while practitioners will look at it at the immediate reaction from the market which is rather a short-term point of view. This must be so since academicians would most probably believe in the result of researchers than a knee-jerk reaction to what happens in a certain stock market. Practitioners, in turn, would like to be guided by academicians but not necessarily. Indeed Miller saw what practitioners perceived as â€Å"an optical illusion† where he used as an example with his students a stick in the water to illustrate his point. He explained that of one who uses his or her eyes and look at the stick in the water, it appears bent yet if one feels it with his or her finger or if one pulls it out of the water one will realize that the stick is not really bent. It is just the loo ks of it that is bent.

In What Circumstances Can a State Lawfully Resort to the Use of Essay

In What Circumstances Can a State Lawfully Resort to the Use of Military Force in Response to an Attack from a Non-State Actor - Essay Example Understanding the details of the circumstances as well as how one can respond to specific attacks is essential not only with the mechanics of how to respond but also with how this associates with the different effects which occur when one responds. This research study will investigate the basic regulations, exceptions and the different laws which create alternative mechanics toward responding from an attack of a non – state actor. Legalities of Military Force Article 51 of the United Nations charter is the basic concept that identifies when one can respond to another with self – defense. In this article, it states that if the inherent rights of the individual are attacked then there is the right to react with self defense toward the non – state actor. However, there are also implications of international peace and security with the expectation that one will pass the attack through the UN before beginning action. The need to restore and keep international peace an d security then become important with the self – defense and the way in which this creates a specific alternative to the international needs. While there is the ability to act with group or self – defense, the concept of international peace and security remain as important when deciding to use military force against an individual1. The first implication which allows one to respond with self defense is if the approach is an armed attack, which makes one a victim to the attack. An armed attack is inclusive of a military attack or operation that uses force in another state. This also includes bombardment with the use of weapons, blockades of another state, an attack with armed forces, acts of aggression and mercenaries that are sent to perform military actions. Each of these instances causes one to become a victim of the actions and constitute the right to react with military force against the other state for self defense. It is noted that there are instances which do not consist of military or armed attacks, including diplomatic missions, cyber attacks, supplies of financial or intelligence resources or frontier incidences. These do not cause one to be a victim of the attack and do not justify countermeasures as they are not proportionate with the violations that occur. There are also implications that the attack must be toward territory or warships and not toward nationals or diplomats as these are not a threat to the self defense of a country2. The use of self defense and the legalities which are associated with this continue with the requirements that are met for a reaction. The first of these is the necessity, meaning that there is no alternative means of redress, such as a treaty or other form of diplomacy. The second is based on the proportionality. If there is another means of changing the process from self defense, then the attack must not be repealed and proportions need to be altered. The need to have immediacy is also a part of the regul ations with the understanding that this needs to be flexible until there is permission to move forward. It should also be noted that the actions cannot take place unless an action has already caused the state to become a victim. One cannot act preemptively before the threat or the attack occurs as there is not an understanding of

Chem Answers Essay Example for Free

Chem Answers Essay Exercise 1. What safety equipment is available to you while you do your experiments? How far are they from you while you are conducting your experiments?This includes fire extinguishers, phones, showers, etc. The safety equipment that I have access to while performing my experiments are as follows; shower, fire alarms and a telephone. They are all within ten feet from where the experiment will take place. 2. What is an MSDS? MSDS is a document that is required by Osha’s â€Å"Hazard Communication† for all existing chemicals that are currently sold. 3. What can make glassware unusable? Glassware is unusable in an experiment when it is chipped, broken, or cracked. 4. When should you wear goggles in the lab? You should wear safety goggles at all time. 5. How long should you wash your eyes if you get a chemical in them? If you have contact with chemicals in your eye, it should be rinsed for ten minutes. 6. What should you do if your clothing catches on fire? If your clothes should catch on fire during your experiment, you should use the safety shower if you have one. Otherwise, stop-drop-roll and yell or use a fire blanket. 7. How should you heat the liquid in a test tube to a temperature less than 100 C? If you are heating liquid in a test tube to a temperature less than 100 degrees. You should use a test tube holder, clamp and hot water. 8.   What do the following symbols mean? DangerousOxidizerRadioactiveCorrosive ________________ _________________ _______________ ______________ 9. What does each of the small diamonds in the NFPA fire diamond mean? Blue- Health section Red- Flammability Yellow- Reactivity White- Special condition 10. Why should you remove jewelry prior to entering the lab for an experiment? Jewelry should always be removed prior to an experiment. Rings can trap the chemical that you are working with against the skin. Necklaces can dangle and knock dangerous chemical over. 11. What type of clothing should you wear in lab? The type of clothing that you should wear would be; leather shoes, long pants or skirts, sturdy cotton fabric, and older clothes are advised. 12. If your Bunsen burner goes out or you smell gas, what should you do? If you should be working with a Bunsen burner and the flame should extinguish or you smell gas, turn the gas off.

Therapeutic Intervention And Women Experiencing Domestic Violence Social Work Essay

Therapeutic Intervention And Women Experiencing Domestic Violence Social Work Essay There have been on-going public and professional concerns about the issue of domestic violence in the world. This interest has resulted in a growing body of research evidence which examine the prevalence and correlates of this type of violence (Archer, 2002; Fagan Browne, 1994; Johnson Ferraro, 2000). The most common form of violence against women is domestic violence, or the violence against women in families. Research consistently demonstrates that a woman is more likely to be injured, raped or killed by a current or former partner than by any other persons. Men may kick, bite, slap, punch or try to strangle their wives or partners; they may burn them or throw acid on their faces; they may beat or rape them, with either their body parts or sharp objects and they may use deadly weapons to stab or shoot them. At times, women are seriously injured, and in some cases they are killed or die, as a result of their injuries (United Nations Economic and Social Council, 1996). The assaults are intended to injure womens psychological health and bodies, which usually include humiliation and physical violence. Just like torture, the assaults are unpredictable and bear little relation to womens own behaviour. Moreover, the assaults may continue for weeks, and even years. Some women may believe that they deserve the beatings because of some wrong actions on their parts, while others refrain from speaking about the abuse because they fear that their partner will further harm them in reprisal for revealing the family secrets or they may simply be ashamed of their situation (United Nations Economic and Social Council, Report of the Special Reporters on violence against women, E/CN.4/1996/53, February 1996). Physical and sexual violence against women is an enormous problem throughout the world. The perpetrators are typically males close to women, such as their intimate partners and family members. Violence puts women at risk for both short- and long-term sequel which involves their physical, psychological, and social well-being. The prevalence of violence involving women is alarming and it constitutes a serious health problem. No woman is safe from domestic violence, no matter what country or culture she lives in. According to the latest UN report, one in three women is raped, beaten, or abused during her lifetime. The occasion of todays world Eliminate Violence against Womens Day focuses on Iran, where abuse largely goes unreported and officially at least unrecognized. Some researchers have argued that violence is equally a problem for both sexes (Gelles, 1974; Straus, Gelles and Steinmetz, 1980; both cited in Dwyer, 1996). However, as Bograd (1988) points out, this argument ignores the disproportionate rate of male violence against women and that most documented female violence is committed in self-defence. Moreover, it also ignores the structural supports for male violence against women. There is abundant evidence which suggests that violence, against women by their husbands or partners, is a historical and current norm (i.e. Dobash and Dobash, 1988; Geller, 1992; Gordon, 1998). Some of the criticisms of cognitive behavioural therapies are that they tend to ignore social and political factors which affect clients (Enns, 1997). People who are homeless, battered, or poor may not have the financial resources or social support to use some cognitive and behavioural methods. Cognitive-behaviour therapy views that behaviour is primarily determined by what that person thinks. Cognitive-behaviour therapy works on the premise that thoughts of low self-worth are incorrect and due to faulty learning. In addition, the aim of therapy is to get rid of the faulty concepts which influence negative thinking. Furthermore, cognitive behavioural therapies may not attend to clients cultural assumptions about rationality which are rather implicit in such therapies. To make cognitive and behavioural therapies more compatible with the feminist therapy, Worell and Remer (2003) suggested changing labels that stress the pathology of people, focusing on feeling, and integrating ideas about gender-role socialization, rather than using negative or pathological labels such as distortion, irrationality, or faulty thinking. Worell and Remer (2003) suggest that clients explore ideas, based on the gender-role generalizations which appear to be distorted or irrational. For example, rather than labelling the thought that womens place is in the home as irrational, the therapist should explore the actual rewards and punishments for living out this stereotyped belief. By focusing on anger, particularly angry ones which arise as a result of gender-role limitations or discrimination, women can be helped to feel independent and gain control over their lives. Therefore, helping women with their social-role issues, gender-role and power analysis can be helpful in exp loring ways of dealing with societal pressures which interfere with womens development. This is supported by Wyche (2001) who believes that cognitive and behaviour therapies are particularly relevant for women of colour because they focus on the present, providing clients with methods to use in handling the current problems. 1.2 Statement of the Problem Violence by intimate partners has been recognized throughout the world as a significant health problem. For instance, the World Health Organization (WHO) focuses on violence against women as a priority health issue. Violence by intimate partners refers to any behaviour within an intimate partnership which causes physical, psychological, or sexual harm to those in the relationship. Violence against women is a manifestation of historically unequal power relations between men and women (Declaration on the Elimination of Violence Against Women, 1993). According to this Declaration fear is the biggest outcome of violence against women. Fear from violence is a big obstacle of womens independence and results in women to continue seeking the mens support, and in many instances this support results in the vulnerability and dependency of women, and is the main obstacle in the empowerment of womens potentials, which can bring about the development of their capacities and to use their energy in the improvement of society. Violence and abuse across the world are a common phenomenon and are not specific to a particular society, culture or mentality. Women in any given country and society are in one way or another subjected to violence in the private (home) environment or public (social) environment. In view of the irreversible consequences of violence for both the human, social and family structure of society, and for women themselves. This issue must become extra sensitive in the world. In fact, gender-based violence against women is the violation of their human rights and fundamental freedoms, the denial of their spiritual and physical integrity and an insult to their dignity. Violence against women is an obstacle of access to equal objectives, development and peace. The term violence against women is associated to any violent act that is gender-based that results in physical, mental and sexual hurt and suffering. The main reason for the separation of men and women is mental abuse. Mental abuse is an abusive behaviour which hurts and damages the womans honour, dignity and self-confidence. This type of abuse results the loss of perception, loss of self-confidence, various types of depression, womans failure in managing the family, greed at the work environment, the reconstruction of violent behaviour in children, womans dysfunction in the family, turning to sedatives, alcohol, drugs, fortune-telling (Mehrangiz Kar 2000). Violence against women in Iran takes place in a number of ways: 1 Honour killing; 2 Self-immolation; 3 Domestic violence; 4 Prostitution; 5 Human trafficking, women and children in particular. Violence reduces the self-confidence of women in the family. Women, who are abused, usually become depressed, secluded, and withdrawn people. Depression is also one of the most fundamental psychological problems in women who are in domestic violence. (Enayat, Halimeh,2006). Standards for counselling practice was developed in response to reports from women who were dissatisfied with the counselling they received after experiencing domestic violence, and concerns raised by workers in womens domestic violence services (Inner South Domestic Violence Service in Melbourne). According to the Welfare Organization of Iran (2006), the rate of mental illness among women victimized by domestic violence is significantly higher than among other women having hospital contact. It was noted that while an established network existed for domestic violence crisis and support services were designed specifically to meet the needs of women, counselling services tended to be generalized, with only a few practitioners specializing in the area. Furthermore, there has been no study to show counsellors which treatment for the mental health treatment of women who experienced domestic violence is better than the others (WBO, 2006). Family laws in Iran, create inequality between men and women, and these laws do not have the capacity to protect women who live with violent men, and violence has turned into a power tool for men. As the country progresses into an industrial nation, more academically qualified professionals are in great demand in Iran. Women who have experienced domestic violence are subjected to considerable amount of problems concerning mental health related to domestic violence. In a study by A. A. Noorbala, conducted at the Tehran University of Medical Sciences, the prevalence of mental disorders was shown to be 21.3% in the rural areas, and this was 20.9% in the urban areas. According to an old Iranian saying, Women should sacrifice themselves and tolerate. This shows that many women, if not most women, are involved in domestic violence. It happens in private life and a legal complaint can destroy the life of a woman. In other words, parts of the population have the perception that abuse is done in order to keep with the traditions of the society and out of love. Women, who are victims of domestic violence, perceived that their husbands jealous reactions which turn into violence are a sign of their love and attention to them. In a very traditional and religious setting in which many [in Iran] live, their understanding of religion and the interpretation given to them throughout the centuries is that a man can beat his wife. They believe that it is a religious command and the commentators, who have portrayed Islam in this light as a violent religion, have also contributed to the growth of this kind of culture. The police and judicial system are of little help. If a battered woman calls the police, it is unlikely that they will intervene. Ironically, the traditional attitude towards marital conflict in Iran inclines people to mediate between the couple. In many cases, the woman is usually sent back to her violent home. In the Iranian judicial system, there has been no law established to prevent domestic violence. On the contrary, there are many indicators which encourage violence against women in families in the Iranian Islamic penal code. Some authors estimate that the number of intimate relationships with violent husbands is about 20 to 30 percent (Stark Flitcraft, 1988; Straus Gelles, 1986). Broken bones, miscarriages, broken families, death, and some mental health disorders are some of the consequences of battering in intimate relationships. Each year, over one million women seek medical care due to battering (Nadelson Sauzier, 1989). Victims also experience nightmares and somatic consequences, while children who witness abuse may be symptomatic, displaying a high number of somatic, psychological and behavioural problems (Nadelson Sauzier, 1989). In addition to psychological scarring for victims, children, and batterers, there are broader societal repercussions of domestic violence. Williams-White (1989) state that the structural, cultural, and social characteristics of our society continue to perpetuate the victimization of women at all levels. In a way, violence within familial relationships reflects and helps maintain violence and oppression it widely in culture. Jennings (1 987:195) explains this by stating that violent husbands not only contribute to maintaining the level of violence in society, they also reflect a direct manifestation of socially learned sex-role behaviours. Moreover, the prevalence of battering has crossed race, ethnicity, and socioeconomic status (Hotaling Sugarman, 1986). Maltreatment of violence can lead to more violence (Walker, 1984). In systems which do not change, future generations may continue to resort to violence to solve problems. In addition, in many of those systems, violence may become more severe with time. For this reason, it is therefore necessary to work on treating the consequences of violence. However, to date, funding for mental health interventions is still limited, and it often only supports short-term treatment which will not adequately address the long-term symptoms. In view of the special treatment for the mental health of women, counseling centres and support houses for women can reduce the mental health problem of abused women and also reduce the domestic violence statistics. At the Welfare Organizations Counselling Centres in Iran, women who are victimized by domestic violence are treated by social workers and counsellors utilizing the cognitive behaviour therapy. Based on the above discussion, this study also analyzed the comparison of the treatments given to women who have experienced domestic violence, using four different therapies, namely combination therapy (cognitive behaviour therapy and feminist therapy) with cognitive behaviour therapy, feminist therapy and social work skills. Violence can shatter a womans life in many ways. Being a victim of violence is widely recognized as a cause for mental health problems, including post-traumatic stress disorder, depression, anxiety, and panic attacks. Being abused also plays a major role in developing or worsening substance abuse problems. For many women who are affected by violence, their first abuse usually occurred in their childhood or adolescence. Victimized women as childrens mothers frequently end up losing custody of their own children due to allegations of abuse or neglect, and over 50% of child abuse and neglect cases involve parental alcohol and drug abuse. In addition to institutionalized violence against women in Iran, the majority of the women and young girls are facing domestic violence at home at the time when they are still living with their parents. In most cases, it is the father and the other elder male members in the family are among those who first commit the aggression against the women and young girls. According to the latest statistics, two out of every three Iranian women have experienced discrimination and domestic violence from the father or the other male members of their family. For the vast majority of the Iranian women, married life marks the beginning of horror, pain, and humiliation, i.e. being the victim of their husbands and sometimes the other family members. Moreover, eighty one out of 100 married women have experienced domestic violence in the first year of their marriage (Mehrangiz Kar 2000). Even women with outstanding jobs and prestigious social standings are subject to this violation. In most of the cases , this abuse leaves permanent physical and psychological damages for the rest of their lives. Ironically, without saying even a word and with much pain and yet no support, crimes against women have gone unnoticed. Ninety out of 100 women suffer from a severe case of depression, from which they ultimately commit suicide and 71% of those women experience nervous breakdowns. (Mehrangiz Kar 2000). Their methods of suicide include setting themselves ablaze. For them, this is the only way of escaping from segregation and humiliation. For instance in Ilam (a city in Iran), 15 girls set themselves ablaze each month, fighting against oppression or depression (Welfare Organization of Iran, 2005). Looking at how serious this problem has become, it is therefore the responsibility of everyone to fight the oppression against women. Female victims need to believe that they should not be blamed on whatever happens to them. An active participation in the Welfare Organization of Iran to defend the wo mens rights and opposition to the Iranian Islamic fundamentalism is the least one can do to help end the pain and suffering of the victims of violence in both private and public spheres. Violence against women, in human and brutal punishments, such as stoning and complete elimination of the women from the political and social arenas represent some aspects of the modus operandi of fundamentalists leading to institutionalized violence. This also means that the struggle for equality, safety and security cannot be separated from the fight against fundamentalism in Iran. This study made use of the theoretical framework, combining the cognitive-behaviour theory and feminist theory for the mental health of the women who have been victimized by domestic violence. The present study could provide knowledge on the different types of mental health treatments adopted by counsellors at various counselling centres throughout the country. This research also examined the quality of the treatment by combining two therapies (cognitive-behaviour therapy and feminist therapy). Armed with this knowledge, the leaders of the Welfare Organizations, the society, families and counsellors can benefit from the consequences of change in the womens mental health. The suggested theoretical framework would provide a better understanding of the womens mental health and their performance in the society. In summery, battered and abused women need a wide range of responses, flexible services, and supportive policies to enhance their safety and self-sufficiency and to restore their self-esteem and welfare. These might include mental and physical health evaluation and referral; relocation services; confidential advocacy, shelter, and other domestic violence support services; educational and vocational training; legal representation concerning divorce, custody and protective orders; evaluation of immigration status and ethnic or cultural issues; and the effective enforcement of criminal laws and court orders to help free them from their partners control and to keep them and their children safe. We know that women who have suffered abuse are more likely to suffer posttraumatic stress disorder (PTSD), depression, and somatization than those who have never experienced abuse; the more extensive the abuse, the greater the risk of mental health disorder. Womens mental health treatment is an important area to consider for research because (1) girls and women as a group are exposed to more traumatic stressors than boys and men; (2) the mental health of women may be severely affected, resulting not only in immediate psychological symptoms, but also lifetime risk for self-destructive or suicidal behaviour, anxiety and panic attacks, eating disorders, substance abuse, somatization disorder, and sexual adjustment disorders; and (3) psychologists are not regularly trained to work specifically with trauma survivors, which can reduce the effectiveness of the treatment survivors receive. Currently there are 22 crisis intervention centres (womens crisis intervention centre) across the country (Iran), and women can stay in these centres between 6 to 8 months. As violence causes psychological pressures and uncontrolled stresses on and ultimately depression in women generally, this study was intended to find a better and useful treatment in the attempt to improve the treatment for the mental health of the women who have become the victims of domestic violence. The present study would also provide further knowledge and understanding on the three different types of the treatments used, namely the Cognitive-behaviour therapy (CBT), Feminist therapy and the combination of the two treatments. The results of this study would therefore contribute the theoretical development and practice in counselling. 1.6 Operational Definition of Terms 1.6.1 Domestic violence Domestic violence is a pattern of coercive behaviour, which includes physical, sexual, economic, emotional and/or psychological abuse, exerted by an intimate partner over another with the goal of establishing and maintaining power and control. 1.6.2 Mental health a state of mind characterized by emotional well-being, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life. Mental Health is the balance between all aspects of life social, physical, spiritual and emotional. It impacts on how we manage our surroundings and make choices in our lives clearly it is an integral part of our overall health. In this study, mental health refers to the score which the client gets from the SCL-90-R test. 1.6.3 Cognitive behaviour Therapy (CBT) A set of principles and procedures that assume that cognitive processes affect behaviour and conversely that behaviour affects cognitive processes. It emphasizes a here-and-now process without emphasizing causation. (D.Meichenbaum) .A treatment approach that helps clients examines and changes the relationship consequences, thoughts, feelings, behaviours and resultant consequences. It incorporates a number of diverse intervention (for example, cognitive restructuring procedures, problem solving, coping skills interventions, stress inoculation training, and self instructional training. 1.6.4 Feminist Therapy A philosophical and practical approach with certain assumptions; for example, strategies are needed, and therapists must be aware of personal, gender-biased value system in relation to appropriate behaviour. Feminist therapists promote se4lf-awareness, self-affirmation, and personal integration, outcomes that may conflict with the societal norms that were the original source of dysfunctional behaviour patterns of women.

Whats Wrong With Cheating? Essay -- Cheating Essays

In a poll taken at Iowa State University, 53% of the upper-class students cheated on a test or plagiarized a paper while at Iowa State, 91% know someone who has, and 18% know someone who has been punished for cheating. (Bishop) What is driving this increase in academic dishonesty, and what are the effects of an academic career that thrives on cheating? There are numerous reasons why people cheat, but, regardless of whether they get caught or not, there are negative consequences. The motives students have for cheating are varied. No matter what the individual reason for someone to be tempted to cheat, their motives can generally be categorized as either based on a fear of failure or pressure to perform. Whether the student simply forgot to study and still desires a good grade, is afraid that they aren’t intelligent enough to pass without cheating, or is too lazy to do the work required to succeed, the underlying cause is a fear of failure or from pressure to perform. Once the line is crossed, and temptations become actions, there are other factors that come into play. In our current society, strong ethics are not highly valued. There is a prevalent attitude that claims: everybody is doing it, it doesn’t hurt anybody, and this material isn’t really important to me. These people don’t possess a profound and thorough understanding of how cheating will harm them. We are consumed with the concept of instant gratification. Our society is near-sighted. Technology makes cheating so easy and convenient, but we often can’t perceive what the long term effects will be if that line between working for your grade and taking the easy way out is crossed. Most people believe that the consequences of cheating are co... ..., fear of receiving a low grade, or pure laziness, the results of cheating are severe. Even though getting caught and corrected may seem like the most obvious consequence of cheating, it almost seems insignificant when compared to the alternative. In reality, ramifications of getting away with repeated cheating are even more daunting. Maybe if students understood all the implications of cheating then it would not be considered as an option. Works Cited What's wrong with cheating? Professor Michael Bishop Chair of the Iowa State University Department of Philosophy and Religion http://dsa.csupomona.edu/judicialaffairs/whatswrong.asp What are the causes and effects of cheating on an exam? https://www.123helpme.com/view.asp?id=14078 Cause and Effect Essay - Plagiarism and Cheating http://answers.yahoo.com/question/index?qid=20080218113757AAxt2cx

SWOT: The Better Way Company Essay -- gardening, revenue, segmentatio

The Better Way Company started in 1988 in a 3 unit building with 10 employees. This was the brainchild of Dr. Amornthep Deerojanawong who wanted to bring quality products to Thailand consumers at an affordable price. The company started with 10,000,000Baht and its current sales for 2012 were 10,000 million Baht (â€Å"History†, 2014). In addition its current office is a luxurious building site on 30 acres located on Ramkhamhaeng Road in the suburbs of Bangkok boasting â€Å"Future Gardening† by French botanist Mr. Patrick Blanc (â€Å"History†, 2014). The company has quickly grown with its direct selling approach, fast deliver of products and increase branding. The company has combated several issues over the years to gain market share, loyal customer base and an increased sales force. In addition, the company experienced a major setback during the flooding but was able to regroup and reestablish its self very quickly. When the founder died, his son Danai Deerojanawong took over the operation of Better Way with a vision to grow the company into a national brand (â€Å"About Us†, 2014). The company has maintained a competitive edge with its technological warehouse and upgraded technological call center. This system tracks the production, orders and inventory to ensure available of product and accuracy of orders. The Better Way company has received several award and world certifications including GMP-Food and Drug Administration Ministry of public Health Bangkok, Thailand; TUV Cert-ISO 9001:200, GMPH, NOF, R&D, Thailand Best, Thailand Super brand 2004-Gold, Super brand Thailand 2003-2004, Super brand-England-Thailand Choice 2011 and its Fusion HD Powder Foundation on SPF25 received the Cosmetics & Toiletries R&D Award 2011. In addition the c... ...Cited Asean free trade area. (2014, January 8). Retrieved from http://www.asean.org/communities/asean-economic-community/category/asean-free-trade-area-afta-council History. (2014, February 6). Retrieved from http://www.mistine.co.th/en/company/history.php Mistine, (2014, February 7). Retrieved from http://www.mistine.co.th.php About us. (2014, February 6). Retrieved from http://www.mistine.co.th/en/company/about us.php Pongvutitham, A. (2012, January 30). Better way has a big plans for Mistine in asean market. The National. Retrieved from www.nationmultimedia.com/business/Better-way-has-big-plans-for-mistine-in-asean-mark-30174717.html Ferrell, O. C., & Hartline, M. (2011). Marketing strategy. (Fifth ed., pp. ). Mason, OH: South-Western Cengage Learning. Retrieved from https://www.betheluniversityonline.net/mba/SectionFramework.aspx?SectionID=783

Christianity in Crime and Punishment :: Crime Punishment Essays

Christianity in   Crime and Punishment      Ã‚  Ã‚  Ã‚  Ã‚   Fyodor Dostoyevsky wrote, " If someone succeded in proving to me that Christ was outside the truth, and if, indeed, the truth was outside Christ, then I would sooner remain with Christ than with the truth" (Frank 68). It was by no means easy for Dostoyevsky to reach this conclusion. In Dostoyevsky's life, one sees that of an intellectual Prodigal Son, returning to the Father In Heaven only after all other available systems of belief have been exhausted. Reared in a devout Russian Orthodox home, Dostoyevsky as a young man rebelled against his upbringing and embraced the anarchist (and atheistic) philosophies of the intelligentsia, radical students and middle class intellectuals violently opposed to the status quo in Nineteenth-Century Russia (Morsm 50). Dostoyevsky revolutionary stirrings were not unnoticed by the Tsar's secret police, and, in 1849, Dostoyevsky was sentenced to a mock execution followed by ten years' hard labor in a Siberian prison (Morsm 50).      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   One critic said "It has been customary to say that Dostoyevsky re-learnt Christianity in prison." (A Boyce Gibson 19.) There, out of his element and surrounded by hardened criminals, he had plenty of time to contemplate life and read The New Testament (the only book he was allowed). However, it was not until his compulsory army service that Dostoyevsky's faith began to blossom. In the army, Dostoyevsky met a fellow officer and devout Christian named Baron von Vrangel, who befriended the still young Dostoevesky and helped him re-discover the Christian faith (Frank 4).      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Although a professing Christian for the rest of his life, Dostoyevsky was not a "plaster saint." (Until he died, he was plagued by doubts and a passion for gambling.) Instead, Dostoyevsky understood, perhaps better than any other great Christian author, that his faith was created and sustained by one thing only: the grace of God.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is of such grace that Dostoyevsky writes in Crime and Punishment. Although most critics agree that Crime and Punishment's theme is not as deliberately Christian as Dostoyevsky's latter works, the novel's voice is still authentically Christian. Written in 1864, shortly after Dostoyevsky lost his first wife, his brother, and a close friend (Gibson 32); Crime and Punishment

Obstacles

Even with the aided eyesight, It was still hard to see In lass, and I was often forced to sit In the front row, away from my group of friends. Being unable to see as everyone else caused me to believe I wasn't as good as everyone else, and my school work was deemed unsatisfactory. I refused to talk or answer questions In class, and that habit has stuck with me to this day. Although my eyesight will remain Inadequate until It can be surgically fixed, I was able to overcome It In the last few years.I excel In honors and AP classes, earning AS and Bi's, and I have been able to maintain a steady social life. Because of contacts, I gained a ewe level of self-esteem that allowed me to become more open to people and less introverted. I'm no longer afraid to speak in class, although it's still sometimes necessary to move myself to the front of the class to see well. At first, being almost legally blind was an enormous burden, and it takes wide shoulders to carry such an encumbrance.Recently, my eyesight hasn't been too much of a hindrance, but its trouble always makes its appearance known when I play volleyball. Being a Libber/ Defensive Specialist, my job is to pass the balls directly to my setter or close enough where she can get them. This is one of the hardest Jobs on the court, and it's even more difficult because of my eyesight. It is nearly impossible for me to Judge distances because I have little depth perception, and it has become increasingly challenging to see exactly where the ball is going.This makes it hard to pass at times, and can often result in a bad play or even a missed point. My greatest fear is being a disappointment to someone, and when this happens, I feel like I'm letting my team and my coach down. My inability to see has crippled both me and my volleyball career, but my determination can help me overcome this adversity. Through practice and willpower, I will improve my skills as a libber, even if my eyesight hinders me more often than not.I c hoose to become better for myself, and to prove to myself and others that my dedication Is stronger than my failures. I refuse to let my disability to get the best of me, In school, volleyball, and my relationships with friends and family. People will always tell you that things will get better, and I'm here to shine some truth on that statement. It won't happen on Its own, however. To achieve happiness or some other goal, you must work diligently to overcome anything In your ay, no matter how tall the mountain Is o how wide the ocean you have to cross.The only way to get across Is to keep going. Especially in sports and school. In class and my social life. Even with the aided eyesight, it was still hard to see in class, and I was often forced to sit in the front row, away from my group of friends. Answer questions in class, and that habit has stuck with me to this day. Although my eyesight will remain inadequate until it can be surgically fixed, I was able to overcome it in the las t few years. I excel in honors and AP classes, earning As and Bi's,Recently, my eyesight hasn't been too much of a hindrance, but its trouble always Specialist, my Job is to pass the balls directly to my setter or close enough where she and others that my dedication is stronger than my failures. I refuse to let my disability to get the best of me, in school, volleyball, and my relationships with friends some truth on that statement. It won't happen on its own, however. To achieve happiness or some other goal, you must work diligently to overcome anything in your way, no matter how tall the mountain is o how wide the ocean you have to cross. The only way to get across is to keep going.